Individual provider Active NPI

Nicole Alexandra Janke

  • Addiction (Substance Use Disorder) Counselor
  • Salem, OR
National Provider Identifier
1093533754
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
2045 Silverton Rd NE
Salem, OR 97301-0100
Phone
(503) 588-5351
NPI assigned
Oct 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

2045 Silverton Rd NE
Salem, OR 97301-0100

Mailing address

625 SE Sheridan Rd Apt D1
Sheridan, OR 97378-2008
Phone (503) 849-1159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marion County CurrentSince Oct 6, 2024 Accepting new patients
Marion County PastSince Oct 6, 2024 Accepting new patients

Locations

2045 Silverton Rd NE
Salem, OR 97301
Phone (503) 576-4589

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1093533754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SE SHERIDAN RD APT D1",
            "city": "SHERIDAN",
            "state": "OR",
            "postal_code": "973782008",
            "telephone_number": "503-849-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 SILVERTON RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010100",
            "telephone_number": "503-588-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANKE",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.